[Sex-dependent differences in endogenous psychoses. A comparison between schizophrenic, schizoaffective and affective...

Sex differences in 355 patients with functional psychoses were investigated longitudinally (mean observation time more than 25 years). Using narrow criteria, 148 patients were diagnosed as having a schizophrenic disorder, 101 as having a schizoaffective and 106 as having an affective disorder. Similarities and differences between male and female patients in these three diagnostic groups were investigated and compared on four levels (premorbid and sociodemographic features, elements of course, symptomatology and the different aspects of outcome) using international standardised instruments of evaluation. A different sex distribution in the three groups was found. Female schizophrenic patients showed a better premorbid social adjustment and a better long-term psychopathological and social outcome than male patients. Differences between male and female schizoaffective patients were found only regarding premorbid personality and polarity, but not regarding symptomatology and outcome. In affective psychoses female patients showed a better social outcome than male patients, but no relevant differences regarding premorbid adjustment were found. Gender differences were found as an important variable for research in functional psychoses, but interactions with other variables have to be considered.